Search

Within the global trend to valorise various mineral wastes as substituents in Portland cement clinker raw feed, mining wastes are promising candidates. However, they might still contain high levels of metallic elements. Their fate in the kiln is not always understood as well as their incorporation within the various clinker's phases. This is especially the case for antimony. Its in situ microanalysis by the means of energy‐dispersive spectroscopy is tricky since several of its L lines (Lα1 = 3604,72 eV, Lα2 = 3595,32 eV) overlap with calcium lines (Kα1 = 3691,68 eV, Kα2 = 3688,09 eV). Hence, at low concentrations, it is not possible to visualise its characteristics peaks. Increasing the counting rate by increasing the acceleration current results in the generation of spurious sum peaks, rendering the analysis not viable. Wavelength dispersive spectroscopy (i.e. electron microprobe) allows a better spectral resolution and quantification of Sb in the clinker phases. In a Portland cement clinker doped with 1% of Sb‐bearing mining waste, the Sb2O3 content in belite and alite is in the 0.2–0.4 wt.% range as well as for C3A; in C4AF the content is higher, from 1.4 wt.% to 2 wt.%. However, there are microstructural evidence that Sb forms blebs from less than 1 μm in diameter up to 10 μm, included in calcium silicates. Hence, its incorporation in the lattice of calcium silicates is dubious. However, for ferrites and aluminates there is no microstructural evidence for remaining Sb‐bearing phases, suggesting a direct incorporation in crystal lattices. LAY DESCRIPTION: Energy‐dispersive spectroscopy (EDS) is widely used in materials science in order to get microchemical information at a micronic scale. This powerful technique allows the quick estimation of almost the whole periodic table with a single detector. However, some troubles might arise when the X‐ray emission lines of an element overlap with another. This is typically the case of Sb, which overlaps with Ca. The present article exemplifies this fact on the basis of the study of Portland cement clinker made with the incorporation of Sb‐bearing wastes. It shows that for dubious analysis, especially in the case of low concentrations, wavelength dispersive spectroscopy (WDS) should be preferred. [ABSTRACT FROM AUTHOR]

Introduction: Polypharmacy is a growing phenomenon associated with adverse effects in older adults. We assessed the potential confounding effects of cumulative anticholinergic burden (ACB) in patients who were hospitalized with falls. Methods: A noninterventional, prospective cohort study of unselected, acute admissions aged ≥ 65 years. Data were derived from electronic patient health records. Results were analyzed to determine the frequency of polypharmacy and degree of ACB and their relationship to falls risk. Primary outcomes were polypharmacy, defined as prescription of 5 or more regular oral medications, and ACB score. Key Results: Four hundred eleven (411) consecutive subjects were included, mean age 83.8 ± 8.0 years: 40.6% men. There were 38.4% patients who were admitted with falls. Incidence of polypharmacy was 80.8%, (88.0% and 76.3% among those admitted with and without fall, respectively). Incidence of ACB score of 0, 1, 2, ≥ 3 was 38.7%, 20.9%, 14.6%, and 25.8%, respectively. On multivariate analysis, age [odds ratio (OR) = 1.030, 95% CI:1.000 ~ 1.050, P = 0.049], ACB score (OR = 1.150, 95% CI:1.020 ~ 1.290, P = 0.025), polypharmacy (OR = 2.140, 95% CI:1.190 ~ 3.870, P = 0.012), but not Charlson Comorbidity Index (OR = 0.920, 95% CI:0.810 ~ 1.040, P = 0.172) were significantly associated with higher falls rate. Of patients admitted with falls, 29.8% had drug‐related orthostatic hypotension, 24.7% had drug‐related bradycardia, 37.3% were prescribed centrally acting drugs, and 12.0% were taking inappropriate hypoglycemic agents. Conclusion: Polypharmacy results in cumulative ACB and both are significantly associated with falls risk in older adults. The presence of polypharmacy and each unit rise in ACB score have a stronger effect of increasing falls risk compared to age and comorbidities. [ABSTRACT FROM AUTHOR]

Background: Conventional superior access for cardiac implantable electronic devices (CIEDs) is not always possible and femoral CIEDs (F‐CIED) are an alternative option when leadless systems are not suitable. The long‐term outcomes and extraction experiences with F‐CIEDs, in particular complex F‐CIED (ICD/CRT devices), remain poorly understood. Methods: Patients referred for F‐CIEDs implantation between 2002 and 2019 at two tertiary centers were included. Early complications were defined as ≤30 days following implant and late complications >30 days. Results: Thirty‐one patients (66% male; age 56 ± 20 years; 35% [11] patients with congenital heart disease) were implanted with F‐CIEDs (10 ICD/CRT and 21 pacemakers). Early complications were observed in 6.5% of patients: two lead displacements. Late complications at 6.8 ± 4.4 years occurred in 29.0% of patients. This was higher with complex F‐CIED compared to simple F‐CIED (60.0% vs. 14.3%, p =.02). Late complications were predominantly generator site related (n = 8, 25.8%) including seven infections/erosions and one generator migration. Eight femoral generators and 14 leads (median duration in situ seven [range 6–11] years) were extracted without complication. Conclusions: Procedural success with F‐CIEDs is high with clinically acceptable early complication rates. There is a notable risk of late complications, particularly involving the generator site of complex devices following repeat femoral procedures. Extraction of chronic F‐CIED in experienced centers is feasible and safe. [ABSTRACT FROM AUTHOR]

Despite the introduction of coronary stents and effective anticoagulation regimens, the treatment of ostial lesions is limited by high restenosis rates. Initial results have been published asserting that statin therapy is associated with a significant reduction in restenosis after stent deployment. However, no information is available about the effect of statins after ostial stenting. Between 1993 and 2000, 122 patients required ostial placement of coronary stents at the Royal Brompton Hospital in London, United Kingdom. Statin treatment was continued or begun in 52 patients with a documentated hypercholesterolemia. Follow-up was feasible in 97 patients undergoing successful stent implantation. Restenosis rate was lower in patients receiving statins, but did not differ significantly from the nonstatin group (34.6% as against 42.2%, P= 0.531).(J Interven Cardiol 2004;17:301–306) [ABSTRACT FROM AUTHOR]